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NPI Code Detail

MEDICARE: DEBORAH JANE HAASE D.D.S.

MEDICARE: DEBORAH JANE HAASE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry15420TX

General Provider Information

NPI Number : 1316150956
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH JANE HAASE D.D.S.
Provider Business Mailing Address
First Line : 2522 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-521-1202
Fax Number : 713-521-1203
Provider Business Practice Location Address
First Line : 2522 NOTTINGHAM ST
Second Line :
City : HOUSTON
State : TX
Zip : 77005-1412
Country : US
Telephone Number : 713-521-1202
Fax Number : 713-521-1203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 07/08/2007

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